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Botulinim Toxin Treatment

The botulinum toxin is a neurotoxin that helps relax an overly tense muscle by blocking the release of certain chemical substances at the nerve-muscle junction. It is also thought to interfere with the release of pain signals underlying its effect on migraine. These characteristics of the toxin have been utilised by specialised neurology centres around the world, benefitting hundreds of patients each day.

Dr. Nabeel Sheikh has a very keen interest in the use of botulinum toxin for the management of various neurological conditions as mentioned below.

Chronic migraines – intractable migraines not responding to maximal medical therapy and occurring on at least 15 days in a month can also benefit from botulinum toxin.

Cervical Dystonias – involuntary contraction of neck muscles leading to abnormal turning or twisting of head to one side.

Limb Dystonias – excessive tightness of muscles in the upper or lower limbs leading to abnormal posturing or movement.

Hemifacial spasm – involuntary twitching of one eye with or without twitching of the same side of face.

In addition, trigeminal & post herpetic neuralgia, spastic disorders and tremor may also benefit from this therapy.

Depending upon the clinical condition, the toxin is administered by a local injection just under the skin or in the muscle. The procedure may require the guidance of electromyography. The procedure, although associated with mild discomfort, is generally well tolerated. An initial detailed appointment is necessary to ensure the suitability of treatment to the clinical condition. The follow up appointments are short, approximately 20 minutes. The maximum effect of therapy occurs between day 7 to 14 and repeat injections are needed on 3 monthly basis.

Nerve Conduction Studies

This test involves placing surface electrodes on skin just above a nerve and measuring the speed and quality of transmission of electric impulse through it. The test helps diagnose nerve damage which may be traumatic or part of another neurological disease. Conditions that may cause nerve damage include pressure on nerve e.g., carpel tunnel syndrome. The test is often used to identify the underlying cause for pain (e.g., sciatica), tingling or numbness affecting certain parts of body (nerve degeneration broadly called neuropathy).

This test may also involve putting a small needle into some of the muscles to assess their function or any muscle damage e.g., in disorders like motor neuron disease.

The electric pulse used is very low voltage, however, the procedure may cause some discomfort depending upon the underlying condition.

It is recommended to wear loose clothing and avoid application of any skin creams or lotions.

Please inform if you are on any blood thinning medications prior to your appointment.